Breast cancer survival in Ethiopia: a systematic review and meta-analysis of rates and predictors.

Abstract

Background: Evidence on breast cancer survival and factors affecting survival is crucial for evaluating treatment effectiveness and formulating breast cancer control strategies. Although original research has been conducted on the survival rate of breast cancer patients and their determinants in Ethiopia, there is a shortage of comprehensive scientific evidence. The present study systematically reviewed literature on the survival rate of breast cancer patients and the predictors of survival in Ethiopia.

Methods: A comprehensive search was conducted in the PubMed, HINARI, Global Index Medicus, and Google Scholar databases up to August 26, 2024. Without any design restrictions, studies on breast cancer patients that measured survival at different time points in Ethiopia were included. The results are summarized in a table, the survival rates are pooled, and risk factors are narratively synthesized. To assess the risk of bias, the Newcastle Ottawa Scale was utilized. Heterogeneity between studies was assessed using the I² statistic. Potential publication bias was assessed using a funnel plot. To examine robustness, a leave-one-out sensitivity analysis was performed.

Results: The pooled survival rates in the first, second, third, fifth, and sixth years were 90%, 70%, 68%, 46%, and 44%, respectively. Advanced age, lower socioeconomic status, late clinical stage, delayed diagnosis, higher histological grade, metastasis, lymph node involvement, presence of comorbidity, tumor size, and estrogen receptor positive were factors that increased the risk of mortality in the included studies.

Conclusion: Survival rate of breast cancer patients in later time including fifth and sixth years was comparably lower than other countries. It is crucial to raise awareness about breast cancer screening, early diagnosis, and therapy initiation to increase the survival rate of breast cancer patients in Ethiopia. In addition, it is important to emphasize the risky population groups, which includes those with lower socioeconomic status and advanced clinical parameters.